scholarly journals Normal limits for oscillometric bronchodilator responses and relationships with clinical factors

2021 ◽  
pp. 00439-2021
Author(s):  
Kanika Jetmalani ◽  
Nathan J Brown ◽  
Chantale Boustany ◽  
Brett G Toelle ◽  
Guy B Marks ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Population Sample ◽  
Medication Use ◽  
Z Score ◽  
Asthma Diagnosis ◽  
Clinical Factors ◽  
Clinical Interpretation ◽  
Bronchodilator Response ◽  
Normal Limits ◽  
Z Scores

IntroductionWe aimed to determine normal thresholds for positive bronchodilator responses for oscillometry in an Australian general population sample aged ≥40 years, to guide clinical interpretation. We also examined relationships between bronchodilator responses and: respiratory symptoms, asthma diagnosis, smoking and baseline lung function.MethodsSubjects recruited from Sydney, Melbourne and Busselton, Australia underwent measurements of spirometry, resistance (Rrs6) and reactance (Xrs6) at 6Hz, before and after inhalation of salbutamol 200μg. Respiratory symptoms and/or medication use, asthma diagnosis and smoking were recorded. Threshold bronchodilator responses were defined as the 5th percentile of decrease in Rrs6 and 95th percentile increase in Xrs6 in a healthy subgroup.ResultsOf 1318 participants, 1145 (570 female) were analysed. The lower threshold for ΔRrs6 was −1.38 cmH2O.s.L−1 (−30.0% or −1.42 Z-scores) and upper threshold for ΔXrs6 was 0.57 cmH2O.s.L−1 (1.36 Z-scores). Respiratory symptoms and/or medication use, asthma diagnosis and smoking all predicted bronchodilator response, as did baseline oscillometry and spirometry. When categorised into clinically relevant groups according to those predictors, ΔXrs6 was more sensitive than spirometry in smokers without current asthma or COPD, approximately 20% having a positive response. Using absolute or Z-score change provided similar prevalences of responsiveness, except in COPD in whom responsiveness measured by absolute change was twice that for Z-score.DiscussionThis study describes normative thresholds for bronchodilator responses in oscillometry parameters, including intra-breath parameters, as determined by absolute, relative and Z-score changes. Positive bronchodilator response by oscillometry correlated with clinical factors and baseline function, which may inform clinical interpretation of oscillometry.

Dental Caries Severity and Nutritional Status of Nigerian Preschool Children

2021 ◽  
pp. 238008442110021
Author(s):  
O.O. Olatosi ◽  
A.A. Alade ◽  
T. Naicker ◽  
T. Busch ◽  
A. Oyapero ◽  
...  
Keyword(s):  
Early Childhood ◽  
Dental Caries ◽  
Nutritional Status ◽  
Early Childhood Caries ◽  
Z Score ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Malnourished Children ◽  
Z Scores ◽  
Childhood Caries

Introduction: Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child’s nutrition and growth. Aim: This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria. Study Design: This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used. Results: A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<–3 = severely wasted, –2 to –3 = wasted, –2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft ( r = −0.181, P < 0.05 and r = −0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant ( r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively). Conclusion: Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight. Knowledge Transfer Statement: The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.

scholarly journals Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort

2017 ◽  
Vol 50 (6) ◽  
pp. 1701659 ◽  
Author(s):  
Myrofora Goutaki ◽  
Florian S. Halbeisen ◽  
Ben D. Spycher ◽  
Elisabeth Maurer ◽  
Fabiën Belle ◽  
...  
Keyword(s):  
Lung Function ◽  
Primary Ciliary Dyskinesia ◽  
Repeated Measurements ◽  
World Health ◽  
Z Score ◽  
Multilevel Regression ◽  
Growth And Nutrition ◽  
Diagnostic Certainty ◽  
Z Scores ◽  
Ciliary Dyskinesia

Chronic respiratory disease can affect growth and nutrition, which can influence lung function. We investigated height, body mass index (BMI), and lung function in patients with primary ciliary dyskinesia (PCD).In this study, based on the international PCD (iPCD) Cohort, we calculated z-scores for height and BMI using World Health Organization (WHO) and national growth references, and assessed associations with age, sex, country, diagnostic certainty, age at diagnosis, organ laterality and lung function in multilevel regression models that accounted for repeated measurements.We analysed 6402 measurements from 1609 iPCD Cohort patients. Height was reduced compared to WHO (z-score −0.12, 95% CI −0.17 to −0.06) and national references (z-score −0.27, 95% CI −0.33 to −0.21) in male and female patients in all age groups, with variation between countries. Height and BMI were higher in patients diagnosed earlier in life (p=0.026 and p<0.001, respectively) and closely associated with forced expiratory volume in 1 s and forced vital capacity z-scores (p<0.001).Our study indicates that both growth and nutrition are affected adversely in PCD patients from early life and are both strongly associated with lung function. If supported by longitudinal studies, these findings suggest that early diagnosis with multidisciplinary management and nutritional advice could improve growth and delay disease progression and lung function impairment in PCD.

scholarly journals Total and Specific Immunoglobulin E and Their Relationship to Respiratory Symptoms in Quebec Children and Adolescents

2005 ◽  
Vol 12 (8) ◽  
pp. 426-432 ◽  
Author(s):  
Benoît Levesque ◽  
Jean-François Duchesne ◽  
Suzanne Gingras ◽  
Pierre Allard ◽  
Edgar Delvin ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Respiratory Symptoms ◽  
Immunoglobulin E ◽  
Geometric Mean ◽  
Allergic Sensitization ◽  
Population Sample ◽  
Ethnic Origin ◽  
Total Ige ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

BACKGROUND: Respiratory disease is a major cause of morbidity in young people. It is now recognized that atopy plays an important role in the development of chronic respiratory symptoms in children.OBJECTIVE: To examine the determinants and consequences of serum total and specific immunoglobulin E (IgE) in a general population sample of Québec children and adolescents.METHODS: In 1999, 2349 children and adolescents (nine, 13 or 16 years of age) who had participated in a respiratory symptom and disease questionnaire had their total IgE measured. Of these participants, a subsample of 451 children and adolescents was analyzed to detect antibodies to eight specific allergens (ie, allergens of dust mites [Dermatophagoides farinae and Dermatophagoides pteronyssinus], cat, dog, ragweed, Timothy grass, mould [alternaria] and cockroach).RESULTS: The geometric mean of the total IgE was 44.4 U/mL among all participants. Concentrations were higher in boys and increased with age. More than 41% of the participants were sensitized to at least one specific allergen. Such sensitization was strongly associated with the occurrence of respiratory conditions and symptoms, namely asthma, wheezing and rhinitis. Family history, school location and ethnic origin had an impact on the prevalence of atopy and total IgE levels.CONCLUSIONS: Allergic sensitization is a major determinant in the development of asthma, wheezing and rhinitis in children and adolescents in the province of Québec.

scholarly journals The Childhood Growth of Twin Children

1995 ◽  
Vol 44 (3-4) ◽  
pp. 169-178 ◽  
Author(s):  
B. Luke ◽  
S. Leurgans ◽  
L. Keith ◽  
D. Keith
Keyword(s):  
Gestational Age ◽  
Growth Retardation ◽  
Z Score ◽  
Cross Sectional ◽  
Childhood Growth ◽  
Severe Stunting ◽  
Increased Risk ◽  
Z Scores ◽  
Twin Children ◽  
Current Weight

AbstractThe objective of this study was to assess the childhood growth of twin children in terms of the effects of intrauterine growth retardation (IUGR) and discordancy at birth on the incidence and severity of stunting and discordancy in current height and weight. The study was part of a cross-sectional field project conducted at the Annual Twins Days Festival in Twinsburg. Ohio, USA, during 1990, 1991, and 1993, and including all twin children between 2 and 12 years of age. Mothers of twins were interviewed regarding their children's birthweights and gestational age; the twin children were measured for their current heights and weights. The study population included 990 twin children, including 555 boys and 435 girls, of which there were 254 boy pairs and 194 girl pairs. Birthweight for gestational age and current weight and height were each converted into Z-scores and characterized as severe (Z-score <−2,0), or moderate IUGR or stunting (Z-score > −2.0 and < −1.2). For the present study discordancy in birthweight, and current height and weight was calculated for like-gender twin pairs. Only twin children with severe IUGR at birth showed an increased risk of stunting in their current height or weight, and this risk was only for moderate, not severe, stunting. Boy twins with severe IUGR at birth were at increased risk of moderate stunting in their current weight (OR 2.67, 95% CI 1.55, 4.58, P = 0.002), while girl twins with severe IUGR at birth were at increased risk of moderate stunting in their current height (OR 4,09, 95% CI 1.49, 10.99, p = 0.003). Among like-gender twin pairs, there were no differences in mean or categories of birthweight or current weight discordancy, but boy twin pairs did show a significantly greater proportion of current weight discordancy compared to girl twin pairs (p = 0.005). Overall, there was a significant tendency for differences in height and weight between like-gender twin pairs to disappear over time, with the effect being greater for boy twin pairs. We conclude from these findings that twin children tend to overcome growth retardation and discordancy present at birth, and although children who had severe IUGR or discordancy at birth were more likely to have some residual moderate stunting or discordancy in height or weight, they still tended to be within normal values for their gender and current age.

scholarly journals „Z”-scores of anthropometric and motor parameters of girls in aerobic gymnastics

2014 ◽  
Vol 61 (2) ◽  
pp. 55-58
Author(s):  
M. Tibenská ◽  
H. Medeková
Keyword(s):  
Body Weight ◽  
Body Height ◽  
Sport Performance ◽  
Z Score ◽  
Anthropometric Parameters ◽  
Percentage Of Body Fat ◽  
Standing Long Jump ◽  
Z Scores ◽  
Long Jump ◽  
Shuttle Run

Abstract This study presents the evaluation of chosen anthropometric and motor parameters in group of female junior competitors throughout the course of 2-year preparation of aerobic gymnastics by means of Z-scores. The observed group consisted of 12 girls (average age at the beginning of observance 14.08 ± 1.19 years). Evaluation of anthropometric (body height, body weight, body mass index, percentage of body fat, acting body weight) and motor parameters (sit-ups in 30 seconds and 60 seconds, pull-ups to bar, modified push-ups, standing long jump, backwards tandem walking, shuttle run 4×10 m, Jacík’s test) was carried out in standard conditions in nine girls at 3-month intervals. It has been confirmed that female probands with higher Z-score of motor parameters together with lower Z-score of anthropometric parameters achieved higher sport performance during the 2-year observance at competitions, with an exception of one such proband.

The Effect of Phosphate Supplementation on Linear Growth in Children with X-Linked Hypophosphatemia

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 478-481
Author(s):  
Mouin G. Seikaly ◽  
Richard H. Browne ◽  
Michel Baum
Keyword(s):  
Vitamin D ◽  
Standard Deviation ◽  
Linear Growth ◽  
Standard Deviation Score ◽  
Initial Therapy ◽  
Current Therapy ◽  
Height Standard Deviation Score ◽  
Z Score ◽  
Z Scores ◽  
Phosphate Supplementation

Background. X-linked hypophosphatemia is the most common inherited cause of rickets. Current therapy for this disorder includes vitamin D and phosphate supplementation; however, phosphate therapy has been associated with nephrocalcinosis. The purpose of this study is to evaluate the effect of oral phosphate therapy on growth in patients with X-linked hypophosphatemia treated with either calcitriol or dihydrotachysterol (vitamin D). Methods. We retrospectively evaluated the prepubertal growth of 36 children with X-linked hypophosphatemia. The height standard deviation score (Z-score) of patients initially treated with vitamin D alone and the Z-scores of patients treated with vitamin D and phosphate therapy were compared. In addition, the growth of patients treated with vitamin D was compared with that of patients treated with vitamin D and phosphate from the outset of therapy. Results. Patients treated with vitamin D alone for 5.36 ± 2.18 years had an improvement in Z-score from -3.18 ± 1.10 to -2.49 ± 0.66 SDS, ,P &lt; .05. Adding phosphate therapy for patients initially treated with vitamin D alone for 4.83 ± 2.99 years did not further improve Z-score (-2.49 ±0.66 vs -2.35 ± 0.83). Initial therapy with vitamin D and phosphate for 4.33 ± 2.19 years also improved Z-score, (-2.84 ± 1.02 vs -1.98 ± 0.82, P &lt; .05). The change in Z-score was similar to the group treated with vitamin D alone compared with the group treated initially with vitamin D and phosphate (0.65 ± 0.54 vs 0.85 ± 0.65, respectively). Conclusion. These data demonstrate that both vitamin D alone and in combination with phosphate improved linear growth. Adding oral phosphate for children initially treated with vitamin D alone did not improve Z-score. Initial therapy with vitamin D and vitamin D plus phosphate produced similar changes in linear growth.

scholarly journals Longitudinal Maternal Vitamin D Status during Pregnancy Is Associated with Neonatal Anthropometric Measures

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1631 ◽  
Author(s):  
Ellen Francis ◽  
Stefanie Hinkle ◽  
Yiqing Song ◽  
Shristi Rawal ◽  
Sarah Donnelly ◽  
...  
Keyword(s):  
Vitamin D ◽  
Linear Models ◽  
Z Score ◽  
Anthropometric Measures ◽  
Hydroxyvitamin D ◽  
Prepregnancy Bmi ◽  
Z Scores ◽  
Gestational Week ◽  
25 Hydroxyvitamin D ◽  
Lower Birthweight

Findings on maternal 25-hydroxyvitamin D (25[OH]D) and neonatal anthropometry are inconsistent, and may at least be partly due to variations in gestational week (GW) of 25(OH)D measurement and the lack of longitudinal 25(OH)D measurements across gestation. The aim of the current study was to examine the associations of longitudinal measures of maternal 25(OH)D and neonatal anthropometry at birth. This study included 321 mother–offspring pairs enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies–Singletons. This study was a prospective cohort design without supplementation and without data on dietary supplementation. Nevertheless, measurement of plasma 25(OH)D reflects vitamin D from different sources, including supplementation. Maternal concentrations of total 25(OH)D were measured at 10–14, 15–26, 23–31, and 33–39 GW and categorized as <50 nmol/L, 50–75 nmol/L, and >75 nmol/L. Generalized linear models were used to examine associations of 25(OH)D at each time-point with neonate birthweight z-score, length, and sum of skinfolds at birth. At 10–14 GW, 16.8% and 49.2% of women had 25(OH)D <50 nmol/L and between 50–75 nmol/L, respectively. The association of maternal 25(OH)D with neonatal anthropometry differed by GW and women’s prepregnancy BMI (normal (<25.0 kg/m2), overweight/obese (25.0–44.9 kg/m2)). All analyses were stratified by prepregnancy BMI status. Among women with an overweight/obese BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower birthweight z-score (0.56; 95% CI: −0.99, −0.13) and length (−1.56 cm; 95% CI: −3.07, −0.06), and at 23–31 GW was associated with shorter length (−2.77 cm; 95% CI: −13.38, −4.98) and lower sum of skinfolds (−9.18 mm; 95% CI: −13.38, −4.98). Among women with a normal BMI, 25(OH)D <50 nmol/L at 10–14 GW was associated with lower sum of skinfolds (−2.64 mm; 95% CI: −5.03, −0.24), at 23–31 GW was associated with larger birthweight z-scores (0.64; 95% CI: 0.03, 1.25), and at 33-39 GW with both higher birthweight z-score (1.22; 95% CI: 0.71, 1.73) and longer length (1.94 cm; 95% CI: 0.37, 3.52). Maternal 25(OH)D status during pregnancy was associated with neonatal anthropometric measures, and the associations were specific to GW of 25(OH)D measurement and prepregnancy BMI.

scholarly journals Comparing modelled fire dynamics with charcoal records for the Holocene

2014 ◽  
Vol 10 (2) ◽  
pp. 811-824 ◽  
Author(s):  
T. Brücher ◽  
V. Brovkin ◽  
S. Kloster ◽  
J. R. Marlon ◽  
M. J. Power
Keyword(s):  
Land Surface ◽  
Burned Area ◽  
Surface Model ◽  
Model Output ◽  
Z Score ◽  
Fire Dynamics ◽  
Anthropogenic Forcing ◽  
Natural Fire ◽  
Fire Activity ◽  
Z Scores

Abstract. An earth system model of intermediate complexity (CLIMate and BiosphERe – CLIMBER-2) and a land surface model (JSBACH), which dynamically represent vegetation, are used to simulate natural fire dynamics through the last 8000 yr. Output variables of the fire model (burned area and fire carbon emissions) are used to compare model results with sediment-based charcoal reconstructions. Several approaches for processing model output are also tested. Charcoal data are reported in Z-scores with a base period of 8000–200 BP in order to exclude the strong anthropogenic forcing of fire during the last two centuries. The model–data comparison reveals a robust correspondence in fire activity for most regions considered, while for a few regions, such as Europe, simulated and observed fire histories show different trends. The difference between modelled and observed fire activity may be due to the absence of anthropogenic forcing (e.g. human ignitions and suppression) in the model simulations, and also due to limitations inherent to modelling fire dynamics. The use of spatial averaging (or Z-score processing) of model output did not change the directions of the trends. However, Z-score-transformed model output resulted in higher rank correlations with the charcoal Z-scores in most regions. Therefore, while both metrics are useful, processing model output as Z-scores is preferable to areal averaging when comparing model results to transformed charcoal records.

scholarly journals Association of Whole Blood Fatty Acids and Growth in Southern Ghanaian Children 2–6 Years of Age

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 954 ◽  
Author(s):  
Mary Adjepong ◽  
William Yakah ◽  
William Harris ◽  
Esi Colecraft ◽  
Grace Marquis ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Growth Parameters ◽  
Dietary Fatty Acids ◽  
Northern Ghana ◽  
Z Score ◽  
Omega 3 ◽  
Omega 6 ◽  
Z Scores ◽  
Height For Age ◽  
Weight For Age

In Ghana, stunting rates in children below 5 years of age vary regionally. Dietary fatty acids (FAs) are crucial for linear growth. The objective of this study was to determine the association between blood FAs and growth parameters in southern Ghanaian children 2–6 years of age. A drop of blood was collected on an antioxidant treated card and analyzed for FA composition. Weight and height were measured and z-scores calculated. Relationships between FAs and growth were analyzed by linear regressions and factor analysis. Of the 209 subjects, 22% were stunted and 10.6% were essential FA deficient (triene/tetraene ratio > 0.02). Essential FA did not differ between stunted and non-stunted children and was not associated with height-for-age z-score or weight-for-age z-score. Similarly, no relationships between other blood fatty acids and growth parameters were observed in this population. However, when blood fatty acid levels in these children were compared to previously reported values from northern Ghana, the analysis showed that blood omega-3 FA levels were significantly higher and omega-6 FA levels lower in the southern Ghanaian children (p < 0.001). Fish and seafood consumption in this southern cohort was high and could account for the lower stunting rates observed in these children compared to other regions.

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